Medical Conditions

Baby Has Blue Lips or Blue Skin (Cyanosis)

Medically reviewed by Dr. Michael Okonkwo, MD, FAAP · Board-Certified Neonatologist

Content reviewed against published AAP, NIH, AAP guidelines

Editorial policy

Last reviewed:

If your baby has been diagnosed with or you suspect baby has blue lips or blue skin (cyanosis), here is what the evidence says.

The short answer

Blue coloring of the lips, face, or body (cyanosis) in a baby can be a sign of low oxygen and should always be taken seriously. However, there are also harmless causes: acrocyanosis (bluish hands and feet in newborns due to immature circulation) is very common and normal in the first 48 hours of life, and brief blueness of the hands and feet in cold environments is generally normal in young babies. The critical distinction is WHERE the blue coloring appears: blue hands and feet alone are usually benign, while blue lips, tongue, or face (central cyanosis) is potentially serious and needs immediate medical evaluation.

Key takeaways

  • Blue coloring of the lips, face, or body (cyanosis) in a baby can be a sign of low oxygen and should always be taken seriously. However, there are also harmless causes: acrocyanosis (bluish hands and feet in newborns due to immature circulation) is very common and normal in the first 48 hours of life, and brief blueness of the hands and feet in cold environments is generally normal in young babies. The critical distinction is WHERE the blue coloring appears: blue hands and feet alone are usually benign, while blue lips, tongue, or face (central cyanosis) is potentially serious and needs immediate medical evaluation.
  • Usually normal when: Blue hands and feet in a newborn with a pink body and face (acrocyanosis)
  • Call your doctor if: Blue lips, tongue, or face at any time - call 911
“Fever itself is not an illness — rather, it is a sign or symptom that the body is fighting an infection. Fever stimulates certain defenses, such as the white blood cells, which attack and destroy invading bacteria.”
— Fever and Your Child, American Academy of Pediatrics (AAP)

This is one of the most common questions parents ask. Searching for answers means you care.

What Parents Should Know

According to AAP, NIH guidelines, blue coloring of the lips, face, or body (cyanosis) in a baby can be a sign of low oxygen and should always be taken seriously. However, there are also harmless causes: acrocyanosis (bluish hands and feet in newborns due to immature circulation) is very common and normal in the first 48 hours of life, and brief blueness of the hands and feet in cold environments is generally normal in young babies. The critical distinction is WHERE the blue coloring appears: blue hands and feet alone are usually benign, while blue lips, tongue, or face (central cyanosis) is potentially serious and needs immediate medical evaluation. At 0-12 months, acrocyanosis (blue hands and feet with a pink body and face) is normal in newborns and can occur intermittently in young babies when cold. This is harmless. Central cyanosis (blue lips, tongue, face, or body) is NOT normal and requires immediate evaluation - it can indicate a heart defect, respiratory problem, or other serious condition. If your baby's lips or tongue turn blue, check if they are breathing normally and call 911 immediately. Brief blueness around the mouth during a hard cry that resolves immediately is common and usually benign. Persistent or worsening blue color is always an emergency. It is generally considered normal when blue hands and feet in a newborn with a pink body and face (acrocyanosis). However, you should contact your pediatrician promptly if blue lips, tongue, or face at any time - call 911.

Sources: [1], [2], [3]

Normal vs. Concerning

Usually Normal
Worth Discussing
Blue hands and feet in a newborn with a pink body and face (acrocyanosis)
Blue lips, tongue, or face at any time - call 911
Briefly blue hands and feet when cold that pink up with warming
Blue coloring with difficulty breathing, gasping, or choking
Momentary blue tinge around the mouth during a very hard cry that resolves immediately
Blue or gray skin color over the body

When to Seek Immediate Care

  • Blue lips, tongue, or face at any time - call 911
  • Blue coloring with difficulty breathing, gasping, or choking
  • Blue or gray skin color over the body
  • Blue coloring that does not improve with warming or that worsens
  • Your baby becomes limp, unresponsive, or stops breathing
  • Blue coloring during feeding or during physical activity in a toddler (possible heart issue)

By Age

What to expect by age

0-12 months

Acrocyanosis (blue hands and feet with a pink body and face) is normal in newborns and can occur intermittently in young babies when cold. This is harmless. Central cyanosis (blue lips, tongue, face, or body) is NOT normal and requires immediate evaluation - it can indicate a heart defect, respiratory problem, or other serious condition. If your baby's lips or tongue turn blue, check if they are breathing normally and call 911 immediately. Brief blueness around the mouth during a hard cry that resolves immediately is common and usually benign. Persistent or worsening blue color is always an emergency.

1-3 years

Toddlers may develop blue lips temporarily when very cold (swimming in cold water, playing outside in winter) - this resolves with warming and is not concerning. However, blue lips during normal activity, during exertion (running, climbing), or at rest is abnormal and should be evaluated promptly. Blue or purple discoloration around the mouth that occurs with difficulty breathing, choking, or coughing warrants immediate medical attention. Some toddlers who have breath-holding spells may turn blue briefly before resuming breathing - while frightening, this is usually benign but should be discussed with your pediatrician.

What to Tell Your Pediatrician

  • Describe when you first noticed baby has blue lips or blue skin (cyanosis) and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if frequent episodes of blueness around the mouth, even if brief.
  • Mention if blue hands and feet that seem to occur more than expected.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

What Should You Do?

When to take action

Probably normal when...
  • Blue hands and feet in a newborn with a pink body and face (acrocyanosis)
  • Briefly blue hands and feet when cold that pink up with warming
  • Momentary blue tinge around the mouth during a very hard cry that resolves immediately
Mention at your next visit when...
  • Frequent episodes of blueness around the mouth, even if brief
  • Blue hands and feet that seem to occur more than expected
  • Your child turns blue during breath-holding spells (discuss with pediatrician)
  • You notice any blue coloring that concerns you
Act now when...
  • Blue lips, tongue, or face at any time - call 911
  • Blue coloring with difficulty breathing, gasping, or choking
  • Blue or gray skin color over the body
  • Blue coloring that does not improve with warming or that worsens
  • Your baby becomes limp, unresponsive, or stops breathing
  • Blue coloring during feeding or during physical activity in a toddler (possible heart issue)

What You Can Do at Home

  • Keep track of when you notice baby has blue lips or blue skin (cyanosis) — noting the time of day, duration, and any triggers can help your pediatrician.
  • Remember that blue hands and feet in a newborn with a pink body and face (acrocyanosis) — this is generally within the range of normal.
  • At 0-12 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
  • Follow any care instructions from your pediatrician. Keep a written log of symptoms to bring to appointments.
  • While monitoring at home, seek immediate care if blue lips, tongue, or face at any time - call 911.

My Baby Is Breathing Fast

Babies normally breathe faster than adults. A normal respiratory rate for a newborn is 30-60 breaths per minute, slowing to 20-40 by age 1. Brief episodes of faster breathing during excitement, crying, or feeding are normal. However, persistently rapid breathing (tachypnea) at rest, especially with other signs of respiratory distress, may indicate a lung or heart problem that needs prompt evaluation.

My Baby Holds Their Breath Until They Turn Blue

Breath-holding spells are frightening to watch but almost never dangerous. They happen in about 5% of healthy children, usually between ages 6 months and 6 years, and are involuntary responses to strong emotions like frustration, anger, or fear. Your child is not doing this on purpose and cannot control it.

Baby Choking or Coughing on Milk or Liquids

It is common for babies to occasionally cough, sputter, or have milk come out of their nose during feeding, especially in the early weeks. This usually happens because of a fast milk flow (letdown), an immature swallowing coordination, or feeding in a position that is too reclined. Occasional choking episodes during feeding that resolve quickly are usually not serious. Adjusting feeding position, pacing the feed, and using a slower-flow nipple can help.

Baby Heart Murmur - Innocent vs Concerning

Heart murmurs are very common in children - up to 75% of children will have an audible murmur at some point. The vast majority are "innocent" or "functional" murmurs, meaning there is no structural heart problem. These murmurs are simply the sound of blood flowing normally through the heart and are more audible during fever, illness, or excitement. A smaller number of murmurs indicate a structural heart difference that may need monitoring or treatment. Your pediatrician can usually distinguish between the two and will refer for an echocardiogram if there is any concern.

Guide

When to Call the Doctor

General guide on when to call the pediatrician, visit urgent care, or go to the ER.

Frequently asked questions

Is baby has blue lips or blue skin (cyanosis) normal?
Blue coloring of the lips, face, or body (cyanosis) in a baby can be a sign of low oxygen and should always be taken seriously. However, there are also harmless causes: acrocyanosis (bluish hands and feet in newborns due to immature circulation) is very common and normal in the first 48 hours of life, and brief blueness of the hands and feet in cold environments is generally normal in young babies. The critical distinction is WHERE the blue coloring appears: blue hands and feet alone are usually benign, while blue lips, tongue, or face (central cyanosis) is potentially serious and needs immediate medical evaluation.
When should I call the doctor about baby has blue lips or blue skin (cyanosis)?
Blue lips, tongue, or face at any time - call 911 Blue coloring with difficulty breathing, gasping, or choking Blue or gray skin color over the body
When is baby has blue lips or blue skin (cyanosis) normal?
Blue hands and feet in a newborn with a pink body and face (acrocyanosis) Briefly blue hands and feet when cold that pink up with warming Momentary blue tinge around the mouth during a very hard cry that resolves immediately
What causes baby has blue lips or blue skin (cyanosis)?
Blue coloring of the lips, face, or body (cyanosis) in a baby can be a sign of low oxygen and should always be taken seriously. However, there are also harmless causes: acrocyanosis (bluish hands and feet in newborns due to immature circulation) is very common and normal in the first 48 hours of life, and brief blueness of the hands and feet in cold environments is generally normal in young babies. The critical distinction is WHERE the blue coloring appears: blue hands and feet alone are usually benign, while blue lips, tongue, or face (central cyanosis) is potentially serious and needs immediate medical evaluation. Common explanations include: Blue hands and feet in a newborn with a pink body and face (acrocyanosis). Briefly blue hands and feet when cold that pink up with warming.
What should I mention to my pediatrician about baby has blue lips or blue skin (cyanosis)?
You should mention baby has blue lips or blue skin (cyanosis) at your next visit if: Frequent episodes of blueness around the mouth, even if brief. Blue hands and feet that seem to occur more than expected. Your child turns blue during breath-holding spells (discuss with pediatrician).
Is baby has blue lips or blue skin (cyanosis) normal at 0-12 months?
Acrocyanosis (blue hands and feet with a pink body and face) is normal in newborns and can occur intermittently in young babies when cold. This is harmless. Central cyanosis (blue lips, tongue, face, or body) is NOT normal and requires immediate evaluation - it can indicate a heart defect, respiratory problem, or other serious condition. If your baby's lips or tongue turn blue, check if they are breathing normally and call 911 immediately. Brief blueness around the mouth during a hard cry that resolves immediately is common and usually benign. Persistent or worsening blue color is always an emergency.
Is baby has blue lips or blue skin (cyanosis) normal at 1-3 years?
Toddlers may develop blue lips temporarily when very cold (swimming in cold water, playing outside in winter) - this resolves with warming and is not concerning. However, blue lips during normal activity, during exertion (running, climbing), or at rest is abnormal and should be evaluated promptly. Blue or purple discoloration around the mouth that occurs with difficulty breathing, choking, or coughing warrants immediate medical attention. Some toddlers who have breath-holding spells may turn blue briefly before resuming breathing - while frightening, this is usually benign but should be discussed with your pediatrician.
Should I go to the ER for baby has blue lips or blue skin (cyanosis)?
Seek emergency care if blue lips, tongue, or face at any time - call 911, or if blue coloring with difficulty breathing, gasping, or choking. When in doubt, call your pediatrician's after-hours line for guidance.
Does baby has blue lips or blue skin (cyanosis) go away on its own?
In many cases, baby has blue lips or blue skin (cyanosis) resolves on its own, especially when blue hands and feet in a newborn with a pink body and face (acrocyanosis).
AAPNIHAAP

References

  1. [1]American Academy of Pediatrics. Cyanosis. HealthyChildren.org. AAP
  2. [2]National Library of Medicine. Cyanosis in Neonates. StatPearls. NIH
  3. [3]American Academy of Pediatrics. When to Call the Doctor for Newborns. HealthyChildren.org. AAP

Doctor Visit Checklist

Bring this checklist to your next pediatrician visit to discuss Baby Has Blue Lips or Blue Skin (Cyanosis).

Things to mention

  • Describe when you first noticed baby has blue lips or blue skin (cyanosis) and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if frequent episodes of blueness around the mouth, even if brief.
  • Mention if blue hands and feet that seem to occur more than expected.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

Observations to share

  • Frequent episodes of blueness around the mouth, even if brief
  • Blue hands and feet that seem to occur more than expected
  • Your child turns blue during breath-holding spells (discuss with pediatrician)

Urgent signs to report immediately

  • Blue lips, tongue, or face at any time - call 911
  • Blue coloring with difficulty breathing, gasping, or choking
  • Blue or gray skin color over the body

My notes

From ismybabyalright.com — free, evidence-based baby health guides

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members

Related Resources

Well-Baby Visit PrepEmergency ContactsBaby Tracker

Bottom line

Most cases of baby has blue lips or blue skin (cyanosis) are normal. Talk to your pediatrician if blue lips, tongue, or face at any time - call 911.

Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.

Share:FacebookX

Was this page helpful?

Related Medical Concerns

My Baby Is Breathing Fast

Babies normally breathe faster than adults. A normal respiratory rate for a newborn is 30-60 breaths per minute, slowing to 20-40 by age 1. Brief episodes of faster breathing during excitement, crying, or feeding are normal. However, persistently rapid breathing (tachypnea) at rest, especially with other signs of respiratory distress, may indicate a lung or heart problem that needs prompt evaluation.

My Baby Holds Their Breath Until They Turn Blue

Breath-holding spells are frightening to watch but almost never dangerous. They happen in about 5% of healthy children, usually between ages 6 months and 6 years, and are involuntary responses to strong emotions like frustration, anger, or fear. Your child is not doing this on purpose and cannot control it.

Baby Choking or Coughing on Milk or Liquids

It is common for babies to occasionally cough, sputter, or have milk come out of their nose during feeding, especially in the early weeks. This usually happens because of a fast milk flow (letdown), an immature swallowing coordination, or feeding in a position that is too reclined. Occasional choking episodes during feeding that resolve quickly are usually not serious. Adjusting feeding position, pacing the feed, and using a slower-flow nipple can help.

Baby Heart Murmur - Innocent vs Concerning

Heart murmurs are very common in children - up to 75% of children will have an audible murmur at some point. The vast majority are "innocent" or "functional" murmurs, meaning there is no structural heart problem. These murmurs are simply the sound of blood flowing normally through the heart and are more audible during fever, illness, or excitement. A smaller number of murmurs indicate a structural heart difference that may need monitoring or treatment. Your pediatrician can usually distinguish between the two and will refer for an echocardiogram if there is any concern.

My Baby's Head Shape Looks Abnormal

Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.

Achondroplasia (Dwarfism) in Babies

Achondroplasia is the most common form of short-limbed dwarfism, affecting about 1 in 15,000 to 40,000 births. It is caused by a mutation in the FGFR3 gene and is usually apparent at birth with characteristic features including short limbs, a larger head, and a prominent forehead. Intelligence is normal. With monitoring for specific complications and supportive care, children with achondroplasia lead full, active, and independent lives.